By Elizabeth Eby

Pressure or bed sores occur when pressure on the bony parts of the body reduces the blood supply to a particular area. Circulating blood carries nutrients to the cells and carries out waste products. When the blood supply is reduced, the cells are susceptible to damage and eventual death.

People who use wheelchairs or those who must stay in bed due to illness or injury are subject to bed sores. Conditions that affect blood circulation like diabetes and hardening of the arteries make pressure sores more difficult to heal.  

Symptoms of Bed Sores

Bed sores may hurt and may make it difficult for your loved one to sit or sleep comfortably. 

Damaged skin may turn purple or red and may feel warm to touch. 

Bed sores may be visible after a full-body examination of your loved one. You may see bed sores on the heels and hip bones and other bony areas of the body. The base of the spine, the shoulder blades, the knees, and the back of the head may also be affected. Bed sores are usually found on weight-bearing areas of the body, or bony areas of the body such as hips or ankles.

Preventing Bed Sores –The Two-Hour Rule

Bed sores can occur in a very short time on a loved one who is confined to a chair or a bed. If left untreated, the skin can progress from red spots to open wounds. Serious, painful infections may occur.

Bed sores are a serious injury and they need to be properly cared for. If you notice a bed sore on your loved one, please consult your health care professional immediately.

While preventing bed sores may be difficult for someone who is bedridden, there are steps you can take to decrease the risk. The most important step is to avoid prolonged pressure on any one part of the body.  Help your loved one move at least every two hours.  Avoid putting pressure on existing sores. And use soft pillows to prop your loved one up in bed, under their buttocks while sitting up in bed, or under their knees to elevate their legs a bit. Other tips include:

• Keep Skin Dry
  Keeping skin clean and dry may help prevent bed sores and other infections. Use mild soap and apply moisturizer to prevent the skin from becoming dry and irritated. Use a cornstarch-based powder after bathing to help keep areas dry without dehydrating the skin. Examine your loved one’s body every day and look for discolored skin or other signs of sores.   
  

• Use Supports to Relieve Pressure
  Use pillows and other props to relieve pressure.  For example, a pillow under the knees or feet will shift the pressure.  A rolled towel may be used to form a bridge under your loved one’s bones or to lift the bed sheets off his feet. Special pillows, mattresses, mattress covers, foam wedges, seat cushions, and other equipment may be available at medical equipment stores. Ask your local pharmacist or other health care professional for ideas on where to locate these types of products.
• Sit in a Chair
  Sitting up straight, rather than always lying down, may help reduce the pressure of the “sit bones” and allow your loved one to move more easily.  Changing positions every two hours (see the “Two-Hour rule” above), if possible, may also help prevent bed sores. Massaging your loved ones back and other weight-bearing areas to stimulate circulation may also help.

Treating Pressure Sores

Bed sores are a serious injury and they need to be properly cared for. If you notice a bed sore on your loved one, please consult your health care professional immediately.

Before treating a bed sore, you should obtain advice from your physician or other health care professional. Do not attempt to diagnose a bed sore yourself unless you are a certified professional. However, some helpful tips for keeping sores clean may be applicable.

Changing the dressings (bandages) and keeping sores clean is important.  Ask a health professional to show you how to clean the sore and remove loose material, since changing dressings and removing dead tissue may be painful and requires particular care.  Work with your loved one to determine the best time of day for both of you to change the dressing. If it is too painful, ask the doctor if your loved one can take a pain reliever 30 minutes before you work on the sore. 

Infected Pressure Sores

Infected sores heal slowly and the infection can spread to other parts of the body. 

Fever or chills, mental confusion, difficulty concentrating, rapid heartbeat, and general weakness are signs that an infection may have spread. Check for signs of infection each day. 

More specific signs of infection include the following:

• Yellow or green pus
• Odor emanating from the sore
• Redness, or warmth around the sore
• Swelling or tenderness around the area

If you notice any of these symptoms, contact your physician immediately.